The literature has indicated that frequently examined patient variables at intake have shown mixed results in the prediction of dropout from outpatient substance abuse treatment. In this research sociodemographic characteristics, substance use and psychological problem severity at intake were examined as predictors of early dropout in 411 patients enrolled in a 6-month outpatient substance abuse treatment program. Early dropout was defined as participation of less than 6 weeks, the first phase of treatment. Another focus of the research was to determine how patients who dropped out of treatment early fared in terms of substance use at 6 months compared to those retained longer. It was found that being younger, unmarried or not cohabitating, and having a greater severity of employment problems at intake were associated with early treatment dropout. Substance abuse and psychological problem severity at intake were not associated with dropout from the first phase of treatment. Patients who left treatment early had some reduction in alcohol consumption at 6-month follow-up, but overall, those retained in treatment longer had better alcohol and drug use outcomes at 6 months. Both the outcomes on retention and substance use were examined in order to explore possible solutions to dropout from the perspective of health services. Despite the improvements in substance abuse for patients retained longer than 6 weeks, it was determined that only 40% of patients were retained for 6 months, thereby indicating that the majority of patients had not received the planned 6-month intervention. In response to these facts, a brief intervention consisting of 5 individual therapy sessions based on coping skills and motivational enhancement strategies was designed and manualized with participation of the clinical staff. Following this, a randomized clinical trial was conducted with 72 patients, and substance use at 6-month follow-up was compared between the brief intervention and the conventional treatment groups. At 6 months, both the brief intervention and conventional treatment groups had reductions in alcohol use compared to intake, but no conclusions could be made about drug use. The implications of the findings for substance abuse treatment service delivery are discussed.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.100370 |
| Date | January 2005 |
| Creators | Gauthier-Faille, Gail. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Psychiatry.) |
| Rights | © Gail Gauthier-Faille, 2005 |
| Relation | alephsysno: 002326137, proquestno: AAINR25152, Theses scanned by UMI/ProQuest. |
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